Charles Michael Goodman, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

8371 Issued in MI

Practice address

28282 Dequindre Rd
Warren, MI 48092-5604

Phone

(586) 574-2620

NPI assigned

Apr 25, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifetime Dental Care of Michigan, P.C.

  • General Practice Dentistry
  • Warren, MI
  • NPI 1477261329
  NPD (past)
• Universal Dental Group P.L.L.C.

  • Dentist
  • Warren, MI
  • NPI 1114041266
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1720346984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28282 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925604",
            "telephone_number": "586-574-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28282 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925604",
            "telephone_number": "586-574-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "8371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Robert Goldstein, DDS
• Maribel Gomez Quesada
• Jose Mateo Gomez, MA, LPC, CAADC, CCS
• Good N Plenty RX LLC
• Grant Connor Goodfellow, D.O.
• Ronald Scott Goodman, D.D.S.
• Laurie E Gordon, DDS
• Kelsie Gore, LLMSW
• Christopher Gorecki, D.D.S.
• Marcena I Gorgaes, D.D.S.

• Dentist in Warren, MI
• Providers in Warren, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.